RESTRICTED HIRE VEHICLE LICENCE

Specific RHV Services

APPLICATION FOR A NEW LICENCE

Please fill in the relevant sections of this form. Your completed form may be lodged at any Service Tasmania shop.

An application fee applies, and also a licence fee. These must be paid at a Service Tasmania shop when lodging the application.

IMPORTANT INFORMATION

This application for a new Restricted Hire Vehicle licence for Specific RHV Services will not be approved unless the Transport Commission is satisfied that the applicant:

-is accredited to operate a passenger transport service in accordance with the Passenger Transport Services Act2011;

-has no outstanding fees due to the Commission; and

-will be the operator of the Restricted Hire Vehicle service that will be provided under the authority of the licence.

The vehicle used under the authority of the licence must be a currently registered small passenger vehicle (a vehicle with a capacity of 9 seats or less including the driver), be registered at Class 16 MAIB premium and be under current inspection.

You will be advised in writing of the outcome of this application. The Commission may require the applicant to provide additional information to demonstrate that these conditions are met before issuing the licence.

SECTION 1 – APPLICANT DETAILS

Name(s):

Address:

Phone:

Email:

Accreditation Number:

SECTION 2 – SIGNATURE(S)

I/we confirm that I/we will be the operator(s) of the Specific Restricted Hire Vehicle service to be provided under the authority of this licence. I understand that I/we am legally responsible for all activity undertaken in respect of this licence. I/we understand that this licence:

-may have conditions imposed on it by the Transport Commission; and

-may be suspended or cancelled without compensation in prescribed circumstances; and

-cannot be leased.

Signature(s) of applicant:

Date:

APPROVAL OF ISSUE

APPLICATION APPROVED/REFUSED

The Transport Commission herewith issues a Restricted Hire Vehicle Licence for Specific Restricted Hire Vehicle services to:

Name(s):

Address:

Licence Number:

Conditions (if any):

Reasons for refusal of application if appropriate:

SIGNED FOR THE TRANSPORT COMMISSION

Name:

Date:

PERSONAL INFORMATION PROTECTION STATEMENT

Personal information we collect from you for Registration and Licensing processes will be used by the Registrar of Motor Vehicles and the Transport Commission for that purpose and may be used for other purposes permitted by the Vehicle and Traffic Act 1999, the Passenger Transport Services Act 2011and the Taxi and Hire Vehicle Industries Act 2008and associated laws. Your personal information may be disclosed to contractors and agents of the Registrar of Motor Vehicles and the Transport Commission, law enforcement agencies, the Motor Accident Insurance Board, vehicle manufacturers (safety recalls only), courts and other public sector bodies or organisations authorised to collect it. This information will be managed in accordance with the Personal Information Protection Act 2004and may be accessed by you on request to this Department. You may be charged a fee for this service. Failure to provide this information may result in your application not being processed or records not being properly maintained.

Application for new RHV Specific licence July 2014Page 1